RARE POSTPARTUM PRIMARY NECROTIZING FASCIITIS OF THE BREAST FOLLOWING MASTECTOMY

CASE REPORT

Authors

  • Luiz Murillo Lopes de Britto Universidade Federal do Rio Grande do Norte
  • Maryane Chagas Barboza Brasilino Universidade Federal do Rio Grande do Norte
  • Thazio Henrique Soares Cardoso de Souza Universidade Federal do Rio Grande do Norte
  • Michelly Nóbrega Monteiro Universidade Federal do Rio Grande do Norte
  • Suzelle Freitas de Moura Oliveira Universidade Federal do Rio Grande do Norte
  • Ricardo Ney Cobucci Universidade Potiguar

Keywords:

Breast, fasciitis, necrotizing, sepsis, mastectomy

Abstract

Primary necrotizing fasciitis (NF) of the breast is extremely rare. It progresses rapidly and can lead to sepsis and multi-organ failure without prompt medical and surgical management. Herein we describe the case of a healthy 42-year-old woman on the 10th day after cesarean section, who was admitted to the intensive care unit (ICU) with a painful and swollen right breast. It evolved rapidly in the ICU into septic shock and nipple discharge. She underwent immediate resuscitation followed by muscle-sparing right mastectomy. She was managed postoperatively in the ICU with intravenous antibiotic therapy. Complications included acute renal failure and anuria, leading to death on the fourth day after surgery. Prompt resuscitation and an aggressive surgical approach are critical to the successful management of this life-threatening pathology. Despite this, NF still carries a high mortality rate.

Downloads

Download data is not yet available.

Author Biographies

Luiz Murillo Lopes de Britto, Universidade Federal do Rio Grande do Norte

Maternidade Escola Januário Cicco, Universidade Federal do Rio Grande do Norte

Ricardo Ney Cobucci, Universidade Potiguar

Gynecology and Obstetrics Department, Universidade Potiguar

References

Stevens D, Bryant A. Necrotizing Soft-Tissue Infections. N Engl J Med. 2017;377(23):2253-65. http://doi.org/10.1056/NEJMra1600673

Misiakos E, Bagias G, Patapis P, Sotiropoulos D, Kanavidis P, Machairas A. Current Concepts in the Management of Necrotizing Fasciitis. Front Surg. 2014;1:36. https://doi.org/10.3389/fsurg.2014.00036

Yang B, Connolly S, Ball W. Necrotising fasciitis of the breast: A rare primary case with conservation of the nipple and literature review. JPRAS Open. 2015;6:15-9. https://doi.org/10.1016/j.jpra.2015.05.002

Shah J, Sharma A, Johri A, Mearns B, O’Donoghue J, Thomas V. Necrotising fasciitis of the breast. Brit J Plastic Surg. 2001;54(1):67-79. http://doi.org/10.1054/bjps.2000.3461

Fayman K, Wang K, Curran R. A case report of primary necrotising fasciitis of the breast: A rare but deadly entity requiring rapid surgical management. Int J Surg Case Rep. 2017;31:221-4. https://dx.doi.org/10.1016%2Fj.ijscr.2017.01.049

Hanif M, Bradley M. Sonographic findings of necrotizing fasciitis in the breast. J Clin Ultrasound. 2008;36(8):517-9. https://doi.org/10.1002/jcu.20492

Nizami S, Mohiuddin K, Mohsin-e-Azam, Zafar H, Memon M. Necrotizing Fasciitis of the Breast. Breast J. 2006;12(2):168-9. https://doi.org/10.1111/j.1075-122X.2006.00227.x

Konik R, Cash A, Huang G. Necrotizing fasciitis of the breast managed by partial mastectomy and local tissue rearrangement. Case Reports Plast Surg Hand Surg. 2017;4(1):77-80. https://doi.org/10.1080/23320885.2017.1364970

Ward N, Harris J, Sloan D. Necrotizing Fasciitis of the Breast Requiring Emergent Radical Mastectomy. Breast J. 2016;23(1):95-9. https://doi.org/10.1111/tbj.12686

Lee J, Lee K, Sun W. Necrotizing fasciitis of the breast in a pregnant woman successfully treated using negative-pressure wound therapy. Ann Surg Treat Res. 2015;89(2):102–6. https://dx.doi.org/10.4174%2Fastr.2015.89.2.102

Yaji P, Bhat B, Harish E. Primary Necrotising Fasciitis of the Breast: Case Report and Brief Review of Literature. J Clin Diagn Res. 2014;8(7):ND01–2. https://dx.doi.org/10.7860%2FJC DR%2F2014%2F9281.4558

Soliman M, Ayyash E, Aldahham A, Asfar S. Necrotizing Fasciitis of the Breast: A Case Managed without Mastectomy. Med Princ Pract. 2011;20(6):567-9. https://doi.org/10.1159/000330026

Angarita F, Acuna S, Torregrosa L, Tawil M, Sánchez E, Heilbron O, et al. Bilateral necrotizing fasciitis of the breast following quadrantectomy. Breast Cancer. 2014;21(1):108-14. https://doi.org/10.1007/s12282-010-0219-4

Flandrin A, Rouleau C, Azar C, Dubon O, Giacalone P. First Report of a Necrotising Fasciitis of the Breast Following a Core Needle Biopsy. Breast J. 2009;15(2):199-201. https://doi.org/10.1111/j.1524-4741.2009.00697.x

Ablett D, Bakker-Dyos J, Rainey J. Primary Necrotizing Fasciitis of the Breast: A Case Report and Review of the Literature. Scott Med J. 2012;57(1):60. https://doi.org/10.1258/smj.2011.011283

Downloads

Published

2018-10-28

How to Cite

Britto, L. M. L. de, Brasilino, M. C. B., Souza, T. H. S. C. de, Monteiro, M. N., Oliveira, S. F. de M., & Cobucci, R. N. (2018). RARE POSTPARTUM PRIMARY NECROTIZING FASCIITIS OF THE BREAST FOLLOWING MASTECTOMY: CASE REPORT. Mastology, 28(4), 244–247. Retrieved from https://revistamastology.emnuvens.com.br/revista/article/view/926

Issue

Vol. 28 No. 4 (2018)

Section

Case Reports

License

Copyright (c) 2018 Luiz Murillo Lopes de Britto, Maryane Chagas Barboza Brasilino, Thazio Henrique Soares Cardoso de Souza, Michelly Nóbrega Monteiro, Suzelle Freitas de Moura Oliveira, Ricardo Ney Cobucci

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.